硬性高透氧性角膜接触镜矫正不规则散光对泪膜稳定性及泪液分泌的影响

Effect of wearing RGP on the stability of tear film and tear secretion after correction of irregular astigmatism

[目的]观察配戴硬性高透氧性角膜接触镜(RGP)矫正不规则散光患者的临床疗效及对泪膜稳定性和泪液分泌的影响。[方法]收集2017年1月至2018年4月36例(38眼)不规则散光患者,测量框架眼镜、RGP眼镜的矫正视力;检测RGP戴镜前及戴镜后1 d、1 mon、6 mon、12 mon的泪膜破裂时间;检测基础泪液分泌试验、泪河高度、干眼症状评分及角膜染色情况。[结果]框架眼镜矫正视力0.321±0.154,RGP矫正视力0.658±0.233,二者比较P<0.05,差异有统计学意义,RGP矫正不规则散光优于框架眼镜。泪膜破裂时间、基础泪液分泌、泪河高度在配戴RGP超过6 mon后,与戴镜前比较,P<0.05差异有统计学意义,且随着戴镜时间的延长三者均逐渐减少。干眼症状在戴镜大于6 mon后逐渐明显,与戴镜前比较差异有统计学意义。RGP戴镜后出现了Ⅰ级角膜染色,在戴镜1 d后角膜染色率最高,随时间延长渐稳定。[结论]RGP可以有效矫正不规则散光,但配戴时间超过6 mon可至泪膜不稳定、泪液分泌减少且干眼症状加重。

[Objective]To observe the clinical effect of RGP on irregular astigmatism and its influence on tear film stability and tear secretion.[Methods]36 cases(38 eyes) with irregular astigmatism were collected from January 2017 to April 2018.The corrected visual acuity of frame glasses and RGP glasses were measured,break-up time(BUT),Schirmer I test(SIt),tear river height(TMH),dry eye symptom score and corneal staining(FL) before and 1 day,1 month,6 months,12 months after wearing RGP.[Results ]The corrected visual acuity of frame glasses was 0.321±0.154,and that of RGP was 0.658±0.233.The difference was statistically significant(P<0.05).RGP was superior to frame glasses in correcting irregular astigmatism.The time of tear film rupture,Basal Tear Secretion and height of tear river after wearing RGP for more than half a year were significantly different from those before wearing RGP,P<0.05.The symptoms of dry eye became obvious after wearing glasses for more than half a year,and the difference was statistically significant.RGP showed grade Ⅰ corneal staining after wearing glasses,the highest staining rate was 1 day after wearing glasses,and it became stable with time.[Conclusion] RGP can correct irregular astigmatism effectively,but more than half a year may result unstable tear film,decreased tear secretion and increased dry eye symptoms.